冠状动脉介入治疗促进血管内皮素Ⅰ和血管紧张素Ⅱ的释放

中国临床药理学与治疗学 ›› 2001, Vol. 6 ›› Issue (4): 301-306.

冠状动脉介入治疗促进血管内皮素Ⅰ和血管紧张素Ⅱ的释放

陈绍良, 段宝祥, 叶飞, 方五旺, 胡作英, 黄进, 戴震林, 周陵, 罗俊, 林松, 查铭凡, 耿其吉

南京市第一医院, 南京 210006

收稿日期:2001-07-10 修回日期:2001-08-09 出版日期:2001-08-26 发布日期:2020-11-30

Release of endothelin 1 and angiotensin II induced by percutaneous transluminal coronary angioplasty

CHEN Shao-Liang, DUAN Bao-Xiang, YE Fei, FANG Wu-Wang, HU Zuo-Ying, HUANG Jing, DAI Zhen-Ling, ZHOU Lin, LUO Jun, LIN Song, ZHA Ming-Fan, GEN Qi-Ji

Nanjing First Hospital, Nanjing 210006

Received:2001-07-10 Revised:2001-08-09 Online:2001-08-26 Published:2020-11-30
About author:CHEN Shao-Liang, male, Ph D.Key research is interventional cardiology.

摘要/Abstract

摘要： 目的血管内皮损伤在经皮冠状动脉腔内成形(PTCA) 后的急性与慢性合并症的发生发展中起着重要的作用。本文探讨PTCA 术对血管损伤和缩血管物质的影响。方法 44 例单纯左冠状动脉前降支(LAD) 狭窄的患者, 被随即分配到单纯球囊扩张(BA) 组(11 例), 血管内放射治疗组(VBT, 14 例)及支架组(19 例)。于PTCA 术前及术后即刻, 术后4 h 和24 h 从冠状窦取血, 分别测定内皮素1(ET-1), 血管紧张素Ⅱ(ANG Ⅱ) 及vW 因子(vWF)。7例单纯行冠状动脉造影的患者作为对照组。结果所有PTCA 患者术后即刻ET-1 水平显著增高, 而ANG Ⅱ及vWF 水平在PTCA 术后4 h 开始明显增高。BA 组、VBT 组及支架组间上述指标无明显差异。结论冠状窦血中ET-1 及ANG Ⅱ、vWF 水平的改变反应了PTCA 术对血管损伤的程度。

关键词: 冠状动脉介入治疗, 内皮, 血管痉挛, 再狭窄

Abstract: Aim Endothelial dysfunction plays critical roles in acute and chronic complications after percutaneous transluminal coronary angioplasty (PTCA).Coronary endo thelial injury and the release of vasoactive substances induced by PTCA were investigated.Methods Forty-four patients with ischemic heart disease who underwent elective PTCA to isolated stenotic lesions in left coronary arteries were examined.Eleven patients received balloon angioplasty (BA), fourteen percutaneous int ravascular brachtheraphy (VBT), and nineteen stent implantation.Blood samples were drawn from the coronary sinus immediately before and 4 h and 24 h after PTCA.Levels of plasma endo thelin 1 (ET-1), angiotensin (ANG) Ⅱ, von Willebrand factor (vWF), and thrombomodulin (TM) were measured.Seven subjects who underwent diag nostic coronary angiopg raphy (CAG) were used as control group.Results In all patients, ET-1 levels in the coronary sinus blood significantly increased immediately after PTCA.ANG Ⅱ levels and vWF activity showed significantly increased immmediately 4 h after PTCA.Changes in levels of these markers were similar among the BA, VBT and stent groups.TM levels were elevated in all groups of patients, including those simply undergoing diag nostic CAG.Conclusion Changes in ET-1, ANG Ⅱ and vWF levels in the coronary sinus ref lect coronary endo thelial injury induced by PTCA.

Key words: coronary intervention, endothelium, vasospasm, restenosis

中图分类号:

陈绍良, 段宝祥, 叶飞, 方五旺, 胡作英, 黄进, 戴震林, 周陵, 罗俊, 林松, 查铭凡, 耿其吉. 冠状动脉介入治疗促进血管内皮素Ⅰ和血管紧张素Ⅱ的释放[J]. 中国临床药理学与治疗学, 2001, 6(4): 301-306.

CHEN Shao-Liang, DUAN Bao-Xiang, YE Fei, FANG Wu-Wang, HU Zuo-Ying, HUANG Jing, DAI Zhen-Ling, ZHOU Lin, LUO Jun, LIN Song, ZHA Ming-Fan, GEN Qi-Ji. Release of endothelin 1 and angiotensin II induced by percutaneous transluminal coronary angioplasty[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2001, 6(4): 301-306.

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